Clinics

New patients

We see most new patients at our Bristol Royal Infirmary clinics
(level 4 of the BRI Queen's Building). This allows most
patients to see a surgeon, visit the preoperative assessment clinic
(POAC) and meet with a nurse specialist in one visit. If you
might be eligible for a research trial, you may meet one of the
surgical research nurses.

The Preoperative Assessment Clinic by Video Link at Other
Hospitals

We can now also provide this "one stop" assessment at Southmead
Hospital for some patients. Here, you will meet a surgeon and
lung cancer nurse specialist in person, but will meet some of the
other members of the team (assessment nurse and anaesthetist) via a
video link to the pre-operative assessment team at Bristol Royal
Infirmary. This means that you can have your assessment
closer to your home. We are rolling this service out to other
hospitals, starting at Gloucester Royal in late 2016.

You will not usually need to visit the hospital again until the
morning of your operation.

The Preoperative Assessment Clinic (POAC)

The purpose of this service is to ensure you are in the best
possible health to undergo anaesthesia and surgery. You will be
assessed by a nurse and reviewed by a member of the anaesthetic
team if required. You may need to have some tests such as blood
tests and possibly have examinations of your heart and lungs with
additional tests as required. We aim to make this assessment as
timely as possible, but this is a comprehensive assessment and we
believe it is essential that you are assessed appropriately. You
will be given the name of a preoperative assessment nurse, or 'case
manager', who you can contact should you have any queries or
further health concerns following this appointment and before your
surgery.

POAC is located at A606 on level 4 of the BRI Queens' Building.

Getting fit for surgery

The fitter you are before an operation, the better your chances
of a good outcome. There is a lot that you can do, even in
just a few weeks, to get fit.

-If you are still smoking, try to stop as soon as possible. Your
GP, local hospital or our clinic can help

-If you are on medications for emphysema/COPD, diabetes, high
blood pressure or another long term condition, make sure to take
them regularly.

-Be as active as you can. Regular aerobic (fitness)
exercise is ideal. A half hour walk 3-4 times a week if you
are able is a good start.

Children and teenagers

Children are usually seen in our general adult clinics.
Patients under 16 should bring a parent or guardian with them to
clinic visits. Surgery for those under 16 will be performed at
Bristol Children's Hospital.

Follow up clinics

Many procedures need follow up visits to check on your recovery
and sometimes to discuss results and arrange further
treatment. For lung and other cancer patients, we will often
follow you up in clinic for several years. These clinics take
place in your local hospitals to reduce travelling times
when possible. We currently undertake clinics in the
following hospitals:

Clinic locations and times

Location

Frequency

Day

Time

Bristol Royal Infirmary (BRI)

Weekly

Tuesday, Wednesday, Friday

9am-1pm

BRI nurse-led chest drain clinic

Ward A700

Weekly

Monday

mornings

BRI nurse-led cancer follow up clinic

Weekly

Friday

9am-1pm

Southmead Hospital

Weekly

Wednesday

9am-1pm

Gloucester Royal Hospital*

Four per month

Thursday

2pm-4:30pm

Royal United Hospital Bath*

Weekly

Thursday

9am-11am

Weston General Hospital*

Two per month

Monday

9:30am-11:30am

Yeovil District Hospital*

Monthly

Tuesday

2pm-4pm

Musgrove Park Hospital, Taunton*

Weekly

Thursday

2pm-4:30pm

*clinics currently for post-operative visits only

How often might I need to come back to clinic?

Most lung cancer patients come to clinic for five years
following their surgery. At the start this will be 2-3 weeks
after surgery, then every 4 months for a year. If you remain well
this will reduce to annual visits. In particular cases we
will vary this routine. If another specialty (for example
oncology) is involved, we may adjust your follow up to save
unnecessary journeys.

For benign (non-cancer) patients, usually only one clinic visit
will be needed after your surgery. After some minor
procedures we will just send the results to the doctor who referred
you, and you don't need to come back to our clinic.

Going home after surgery

We will give you a plan for your follow up when you are
discharged. A written clinic letter will normally arrive
within 1-2 weeks of going home. If the date or location is
inconvenient, please tell us and we will try to accommodate
you.

Try and stay as active as possible when you get home.
Spend the day in a chair-not in bed, and keep doing the coughing
and breathing exercise that the physiotherapist has shown
you. Take enough painkillers so that you can cough and
breathe comfortably. Try to get out the house at least
once a day if you can, even if just for a very short walk.
Eat a healthy, balanced diet. Keep taking our laxatives until
your bowels have returned to normal, and wear the surgical
stockings that you had in hospital for most of the day and night
(its OK to take them off to clean them) until you are sure that you
are fully mobile.

Once you are at home, any repeat prescriptions- for example for
painkillers- and other routine issues are usually dealt with by
your family doctor. The practice nurse at your GP will
normally be able to remove any stiches, if necessary. If you
are going home with a chest drain in place, or still need regular
wound dressings, then we will involve your local district nurse
before you go home.

If you have been smoking before surgery, do your best to stay
off cigarettes now that you are at home. Staying off
cigarettes gives you the best chance of staying cancer free.
We will offer you smoking cessation support and nicotine
replacement if appropriate before you go home.

The thoracic nurse specialist team is available if you have any
specific questions about your surgery or follow up, at thoracicCNS@uhbristol.nhs.uk.